Clin Endosc.  2014 Nov;47(6):516-522. 10.5946/ce.2014.47.6.516.

Stricture Occurring after Endoscopic Submucosal Dissection for Esophageal and Gastric Tumors

• Kim GH
• Jee SR
• Jang JY
• Shin SK
• Choi KD
• Lee JH
• Kim SG
• Sung JK
• Choi SC
• Jeon SW
• Jang BI
• Huh KC
• Chang DK
• Jung SA
• Keum B
• Cho JW
• Choi IJ
• Jung HY
• Korean ESD Study Group

• KMID: 2134489
• DOI: http://doi.org/10.5946/ce.2014.47.6.516

Abstract

Endoscopic submucosal dissection (ESD) is a widely accepted treatment for early gastric and esophageal cancer. Compared to endoscopic mucosal resection, ESD has the advantage of enabling en bloc removal of tumors regardless of their size. However, ESD can result in a large artificial ulcer, which may lead to a considerable deformity. Circumferential mucosal defects of more than three-fourths the esophageal circumference, long longitudinal mucosal defects (>30 mm), and lesions in the upper esophagus are significant risk factors for the development of post-ESD strictures of the esophagus. In the stomach, a circumferential mucosal defects more than three-fourths in extent and longitudinal mucosal defects >5 cm are risk factors of post-ESD stricture. If scheduled early, regular endoscopic balloon dilation is effective in controlling and preventing post-ESD stricture. Moreover, intralesional steroid injections or oral steroids can achieve remission of dysphagia or reduce the need for repeated endoscopic balloon dilation. However, further study is needed to improve the prevention of stricture formation.

Keyword

Stricture; Esophagus; Stomach; Endoscopic submucosal dissection

MeSH Terms

Congenital Abnormalities
Constriction, Pathologic*
Deglutition Disorders
Esophageal Neoplasms
Esophagus
Risk Factors
Steroids
Stomach
Ulcer
Steroids

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